Cortical auditory evoked potential in assessment of neonates: a study about minimum level of responses in term and preterm newborns

Didoné, Dayane Domeneghini; Oliveira, Lilian Sanches; Durante, Alessandra Spada; Almeida, Kátia de; Garcia, Michele Vargas; Riesgo, Rudimar dos Santos; Sleifer, Pricila

doi:10.1016/j.bjorl.2019.04.009

Acessibilidade / Reportar erro

Brasil

Brazilian Journal of Otorhinolaryngology

Español English

Brasil

Español English

sumário « anterior atual seguinte »

Sumário

Original article • Braz. j. otorhinolaryngol. 86 (6) • Nov-Dec 2020 • https://doi.org/10.1016/j.bjorl.2019.04.009 copy

Cortical auditory evoked potential in assessment of neonates: a study about minimum level of responses in term and preterm newborns^✰ ✰ Please cite this article as: Didoné DD, Oliveira LS, Durante AS, Almeida K, Garcia MV, Riesgo RS, et al. Cortical auditory evoked potential in assessment of neonates: a study about minimum level of responses in term and preterm newborns. Braz J Otorhinolaryngol. 2020;86:687–95.

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

Introduction:

The study of the threshold level of cortical auditory response in adults has been investigated in previous studies. Due to maturational issues, little is known about these responses in neonates. Technological advances with automatic analysis devices now allow investigation in specific populations. Thus, new studies are needed to establish the feasibility of using this auditory potential to identify the lowest levels of responses in children.

Objective:

Verify and compare latency and amplitude in 80 dBnNA and the minimum level of cortical auditory response in term and preterm neonates.

Methods:

A cross-sectional, comparative study involving 59 neonates, 35 full-term births and 24 preterm births, with positive results in the Neonatal Hearing Screening. The Hearlab system was used to investigate the P1i auditory potential with tone burst stimulus at frequencies of 500, 1000, 2000 and 4000 Hz. The minimum response level search ranged from 80 to 0 dBNA and was detected automatically. The results were compared between groups, evaluating the latency and amplitude in 80 dBNA and the minimum level of cortical auditory response.

Results:

The mean values obtained for the minimum level of cortical auditory response in term group were 26 ± 8.81; 26.14 ± 6.97; 29 ± 7.65 and 29.43 ± 7.04 dBNA and for preterm neonates of 31.96 ± 10.41; 34.13 ± 11.34; 33.64 ± 11.03 and 37.73 ± 11.92 dBNA, for the frequencies of 500, 1000, 2000 and 4000 Hz, respectively. There was a difference between groups for the latency of P1i at 4000 Hz and the minimum response levels at 500, 1000 and 4000 Hz, with higher values for preterm infants.

Conclusion:

It was possible to obtain latency and amplitude values at 80 dBnNA and the minimum level of cortical response in term and preterm newborns, with different results between groups, with higher values in those born preterm.

KEYWORDS
Infant, newborn; Electrophysiology; Auditory threshold; Evoked potentials, auditory

Variables	Total sample (n = 59)	Term (n = 35)	Preterm (n = 24)	p-value
Gestational age (weeks)	Average	39.52	34.05	<0.001^a a Student's t-test for independent sample.
	Minimum	37	28
	Maximum	39.28	36
	SD	1.16	2.39
Age at the time of evaluation (weeks)	Average	40.91	40.37	0.11^a a Student's t-test for independent sample.
	Minimum	39	38
	Maximum	43	43
	SD	1.2	1.3
Ear	Right	14	12	0.44^b b Chi-Square test. The significance level of 5% was adopted.
Ear	Left	21	12
Sex	Female	16	11	0.99^b b Chi-Square test. The significance level of 5% was adopted.
Sex	Male	19	13
Time of assessment (minutes)		70.94	65.54	0.20^a a Student's t-test for independent sample.

Frequency	Group	Average ± SD	Median	1ºQ	2ºQ	3ºQ	Minimum	Maximum	p-value
500 Hz	Term (n = 35)	242.43 ± 39.88	244.00	209.00	244.00	277.00	168.00	313.00	0.92^a a Student's t-test for independent sample.
500 Hz	Preterm (n = 23)	241.35 ± 48.79	237.00	202.00	237.00	267.00	169.00	371.00	0.92^a a Student's t-test for independent sample.
1000 Hz	Term (n = 35)	228.94 ± 34.98	229.00	208.00	229.00	253.00	157.00	307.00	0.25^a a Student's t-test for independent sample.
1000 Hz	Preterm (n = 23)	246.43 ± 47.49	237.50	208.00	235.00	258.00	200.00	370.00	0.25^a a Student's t-test for independent sample.
2000 Hz	Term (n = 35)	233.14 ± 42.65	236.00	205.00	236.00	256.00	137.00	353.00	0.97^a a Student's t-test for independent sample.
2000 Hz	Preterm (n = 22)	232.77 ± 36.54	231.50	201.50	231.50	256.00	170.00	310.00	0.97^a a Student's t-test for independent sample.
4000 Hz	Term (n = 35)	249.97 ± 49.16	243.00	213.00	243.00	271.00	157.00	370.00	0.05^a a Student's t-test for independent sample.
4000 Hz	Preterm (n = 23)	279 ± 60.49	277.00	234.00	269.00	302.00	178.00	398.00	0.05^a a Student's t-test for independent sample.

Frequency	Group	Average ± SD	Median	1ºQ	2ºQ	3ºQ	Minimum	Maximum	p-value
500 Hz	Term (n = 35)	6.71 ± 3.58	6.00	4.00	6.00	9.00	1.00	19.00	0.45^a a U-Mann-Whitney test.
500 Hz	Preterm (n = 23)	7.72 ± 4.27	6.79	4.60	6.71	10.10	2.38	20.02	0.45^a a U-Mann-Whitney test.
1000 Hz	Term (n = 35)	7.08 ± 4.18	7.00	4.00	7.00	8.00	2.00	22.00	0.78^a a U-Mann-Whitney test.
1000 Hz	Preterm (n = 23)	7.73 ± 4.23	7.62	4.58	7.47	10.34	1.94	19.44	0.78^a a U-Mann-Whitney test.
2000 Hz	Term (n = 35)	5.85 ± 2.86	5.00	4.00	5.00	8.00	2.00	14.00	0.09^a a U-Mann-Whitney test.
2000 Hz	Preterm (n = 22)	7.31 ± 3.27	6.03	4.22	6.35	9.35	2.50	13.73	0.09^a a U-Mann-Whitney test.
4000 Hz	Term (n = 35)	5.82 ± 2.96	6.00	3.00	6.00	7.00	2.00	16.00	0.58^a a U-Mann-Whitney test.
4000 Hz	Preterm (n = 23)	6.87 ± 4.41	6.10	3.58	5.59	9.66	2.32	20.47	0.58^a a U-Mann-Whitney test.

Frequency	Group	Average ± SD	Median	1ºQ	2ºQ	3ºQ	Minimum	Maximum	p-value
500 Hz	Term (n = 35)	26.00 ± 8.81	30.00	15.00	30.00	30.00	5.00	40.00	0.04^a a U-Mann-Whitney test.
500 Hz	Preterm (n = 23)	31.96 ± 10.41	30.00	25.00	30.00	35.00	15.00	60.00	0.04^a a U-Mann-Whitney test.
1000 Hz	Term (n = 35)	26.14 ± 6.97	30.00	25.00	30.00	30.00	0.00	35.00	0.00^a a U-Mann-Whitney test.
1000 Hz	Preterm (n = 23)	34.13 ± 11.34	30.00	30.00	30.00	40.00	15.00	60.00	0.00^a a U-Mann-Whitney test.
2000 Hz	Term (n = 35)	29.00 ± 7.65	30.00	30.00	30.00	35.00	0.00	40.00	0.08^a a U-Mann-Whitney test.
2000 Hz	Preterm (n = 22)	33.64 ± 11.03	30.00	30.00	30.00	40.00	5.00	60.00	0.08^a a U-Mann-Whitney test.
4000 Hz	Term (n = 35)	29.43 ± 7.04	30.00	25.00	30.00	30.00	15.00	50.00	0.05^a a U-Mann-Whitney test.
4000 Hz	Preterm (n = 22)	37.73 ± 11.92	30.00	30.00	30.00	35.00	25.00	65.00	0.05^a a U-Mann-Whitney test.

	Term				Preterm
	500 Hz	1000 Hz	2000 Hz	4000 Hz	500 Hz	1000 Hz	2000 Hz	4000 Hz
30 dBHL	77%	97%	71%	74%	60%	60%	50%	59%
35 dBHL	94%	100%	94%	94%	75%	70%	75%	75%
40 dBHL	100%	100%	100%	97%	91%	88%	88%	84%
45 dBHL	100%	100%	100%	97%	91%	88%	88%	84%
50 dBHL	100%	100%	100%	100%	95%	91%	95%	84%
55 dBHL	100%	100%	100%	100%	95%	91%	95%	95%
60 dBHL	100%	100%	100%	100%	100%	100%	100%	95%
65 dBHL	100%	100%	100%	100%	100%	100%	100%	100%

Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial. Sede da Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico Facial, Av. Indianópolia, 1287, 04063-002 São Paulo/SP Brasil, Tel.: (0xx11) 5053-7500, Fax: (0xx11) 5053-7512 - São Paulo - SP - Brazil
E-mail: revista@aborlccf.org.br

Acompanhe os números deste periódico no seu leitor de RSS

[1] ⁎ Corresponding author. dayanedidone@yahoo.com.br